Page 245 - Medicare Benefit Policy Manual

There are two ways in which the level of the subluxation may be specified.

The exact bones may be listed, for example: C5, C6, etc.

The area may suffice if it implies only certain bones such as: Occipito-atlantal
(occiput and C1 (atlas)), lumbo-sacral (L5 and Sacrum), sacro-iliac (sacrum and
ilium).

Following are some common examples of acceptable descriptive terms for the nature of
the abnormalities:

Off-centered

Misalignment

Malpositioning

Spacing - abnormal, altered, decreased, increased

Incomplete dislocation

Rotation

Listhesis - antero, postero, retro, lateral, spondylo

Motion - limited, lost, restricted, flexion, extension, hyper mobility, hypomotility,
aberrant

Other terms may be used. If they are understood clearly to refer to bone or joint space or
position (or motion) changes of vertebral elements, they are acceptable.

240.1.5 - Treatment Parameters
(Rev. 23, Issued: 10-08-04, Effective: 10-01-04, Implementation: 10-04-04)
B3-2251.5

The chiropractor should be afforded the opportunity to effect improvement or arrest or
retard deterioration in such condition within a reasonable and generally predictable
period of time. Acute subluxation (e.g., strains or sprains) problems may require as many
as three months of treatment but some require very little treatment. In the first several
days, treatment may be quite frequent but decreasing in frequency with time or as
improvement is obtained.

Chronic spinal joint condition implies, of course, the condition has existed for a longer
period of time and that, in all probability, the involved joints have already “set” and